Premature rupture of membranes at 34 to 37 weeks' gestation: aggressive versus conservative management.
OBJECTIVE
Our purpose was to compare induction of labor with preterm rupture of membranes between 34 and 37 weeks' gestation with expectant management.


METHODS
In this prospective investigation 120 gravid women at > or = 34 weeks 0 days and < 36 weeks 6 days of gestation were randomized to receive oxytocin induction (n = 57) or observation (n = 63).


RESULTS
Estimated gestational age at rupture of membranes (34.3 +/- 1.4 weeks vs 34.5 +/- 1.4 weeks) and ultrasonographically estimated fetal weight (2230 +/- 321 gm vs 2297 +/- 365 gm) were equivalent between groups (not significant). Chorioamnionitis occurred more often (16% vs 2%, p = 0.007), and maternal hospital stay (5.2 +/- 6.8 days vs 2.6 +/- 1.6 days, p = 0.006) was significantly longer in the control group. Neonatal sepsis was also more common in the observation group (n = 3) than among induction patients (n = 0), but the difference was not statistically significant.


CONCLUSIONS
Aggressive management of preterm premature rupture of the membranes at > or = 34 weeks 0 days of gestation by induction of labor is safe for the infant in our population and avoids maternal-neonatal infectious complications.
Naef
R W
RW
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Allbert
J R
JR
Ross
E L
EL
Weber
B M
BM
Martin
R W
RW
Morrison
J C
JC
D000293:Adolescent; D000328:Adult; D002821:Chorioamnionitis / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000517:prevention & control; D007751:Labor, Induced / Q000379:methods / Q000592:standards*; D007902:Length of Stay; D009017:Morbidity; D010120:Oxytocics / Q000494:pharmacology; D010121:Oxytocin / Q000494:pharmacology; D010346:Patient Care Management / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D014590:Uterine Contraction / Q000187:drug effects / Q000502:physiology
D010120:Oxytocics; D010121:Oxytocin